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Women treated for gynaecological cancer during young adulthood: A mixed-methods study of perceived psychological distress and experiences of support from health care following end-of-treatment
Department of Health Care Sciences, Ersta Sköndal Bräcke University College, Stockholm, Sweden. .ORCID iD: 0000-0001-5104-1281
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Clinical Psychology in Healthcare.
Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.ORCID iD: 0000-0002-2491-2042
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2018 (English)In: Gynecologic Oncology, ISSN 0090-8258, E-ISSN 1095-6859Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE:

To investigate the prevalence and predictors of cancer-related distress in younger women treated for gynaecological cancer, and to explore women's needs and experiences of psychosocial support following end-of-treatment.

METHODS:

Data were collected from 337 gynaecological cancer survivors, 19-39years at diagnosis, using a study-specific questionnaire and the Swedish Quality Register of Gynaecologic Cancer. Predictors of distress were investigated with multivariable logistic regression analysis. Open-ended questions were analysed with content analysis.

RESULTS:

The prevalence of cancer-related distress was 85% (n=286) including fear of cancer-recurrence (n=175, 61%), anxiety (n=152, 53%), depression (n=145, 51%), fear of death (n=91, 32%), concerns regarding sexuality (n=87, 34%) and fertility (n=78, 27%), and changed body image (n=78, 27%). Multi-modal treatment (OR 2.25, 95% CI 1.13-4.49) and a history of psychological distress (OR 3.44, 95% CI 1.41-8.39) predicted cancer-related distress. The majority of women experiencing distress also reported a need for support after end-of-treatment (n=205, 71%). One-third of those receiving support reported the received support as inadequate (n=55, 34%). Eight categories described reasons for not seeking support, e.g., lacked strength to seek professional support and too busy managing every-day life and, wanted help but did not know who to turn to. Four categories described reasons for not receiving sought support e.g., found it difficult to openly express feelings, psychosocial care was under-dimensioned, insufficient and unprofessional.

CONCLUSION:

Results identify the importance of support and longer-term follow-up for young survivors of gynaecological cancer. The support needs to be organised to meet this group's specific needs.

Place, publisher, year, edition, pages
2018.
Keywords [en]
Gynaecological cancer, Psychological distress, Young adulthood
National Category
Cancer and Oncology Nursing
Identifiers
URN: urn:nbn:se:uu:diva-348203DOI: 10.1016/j.ygyno.2018.03.055PubMedID: 29588102OAI: oai:DiVA.org:uu-348203DiVA, id: diva2:1196847
Available from: 2018-04-11 Created: 2018-04-11 Last updated: 2018-05-03Bibliographically approved

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Mattsson, ElisabetEinhorn, KimSundström Poromaa, IngerStålberg, KarinWikman, Anna

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Mattsson, ElisabetEinhorn, KimSundström Poromaa, IngerStålberg, KarinWikman, Anna
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Clinical Psychology in HealthcareReproductive HealthDepartment of Women's and Children's HealthResearch group (Dept. of women´s and children´s health)
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Gynecologic Oncology
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